Clinical research in cardiology : official journal of the German Cardiac Society · 2015
Short tip-big difference? First-in-man experience and procedural efficacy of pulmonary vein isolation using the third-generation cryoballoon.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Heeger Christian-H, Wissner Erik, Mathew Shibu, Hayashi Kentaro, Sohns Christian, Reißmann Bruno, Lemes Christine, Maurer Tilmann, Fink Thomas, Saguner Ardan M, Santoro Francesco, Riedl Johannes, Ouyang Feifan, Kuck Karl-Heinz, Metzner Andreas
Аннотация
BACKGROUND: The second-generation cryoballoon (CB2) provides effective and durable pulmonary vein isolation (PVI) associated with encouraging clinical outcome data. The novel third-generation cryoballoon (CB3) incorporates a 40 % shorter distal tip. This design change may translate into an increased rate of PVI real-time signal recording, facilitating an individualized ablation strategy using the time to effect (TTE).
METHODS AND RESULTS: Thirty consecutive patients with paroxysmal or short-standing persistent atrial fibrillation underwent CB3-based PVI and were compared to 30 patients treated with the CB2. Individual freeze-cycle duration was set to TTE + 120 s for both groups. A total of 118 (CB3) and 119 (CB2) pulmonary veins (PV) were identified and all PVs successfully isolated utilizing the CB3 and CB2, respectively. The real-time PVI visualization rate was 74 % (CB3) and 40 % (CB2; p = 0.001) and the mean freeze-cycle duration 204 ± 88 s (CB3) and 215 ± 90 s (CB2; p = 0.15). Per individual PV, a shorter mean freeze-duration was found for the CB3 and the right superior PVs (188 ± 92 vs. 211 ± 124 s, p = 0.04) and right inferior PVs (192 ± 75 vs. 200 ± 37 s, p = 0.02). No differences were found for the left-sided PVs.
CONCLUSIONS: A higher rate of real-time electrical PV recordings is seen using the novel CB3 as compared to CB2, which may facilitate an individualized ablation strategy using the TTE.
METHODS AND RESULTS: Thirty consecutive patients with paroxysmal or short-standing persistent atrial fibrillation underwent CB3-based PVI and were compared to 30 patients treated with the CB2. Individual freeze-cycle duration was set to TTE + 120 s for both groups. A total of 118 (CB3) and 119 (CB2) pulmonary veins (PV) were identified and all PVs successfully isolated utilizing the CB3 and CB2, respectively. The real-time PVI visualization rate was 74 % (CB3) and 40 % (CB2; p = 0.001) and the mean freeze-cycle duration 204 ± 88 s (CB3) and 215 ± 90 s (CB2; p = 0.15). Per individual PV, a shorter mean freeze-duration was found for the CB3 and the right superior PVs (188 ± 92 vs. 211 ± 124 s, p = 0.04) and right inferior PVs (192 ± 75 vs. 200 ± 37 s, p = 0.02). No differences were found for the left-sided PVs.
CONCLUSIONS: A higher rate of real-time electrical PV recordings is seen using the novel CB3 as compared to CB2, which may facilitate an individualized ablation strategy using the TTE.